Managed Care Analyst II

We are so glad you are interested in joining Sutter Health!

Organization:

SHSO-Sutter Health System Office-Valley

Position Overview:

Provides independent high-level document management to include complex tracking of legal and formal business language to support systemwide contract negotiations and administration on behalf of Sutter affiliates. Creates documents with the highest possible level of accuracy specific to appropriate wording, context and formatting to ensure accurate document interpretation, including tracking document input from multiple parties including legal representatives.

Job Description:

EDUCATION:
Equivalent experience will be accepted in lieu of the required degree or diploma.

• Bachelor's: Accounting, Finance, Economics, Statistics, Business or Healthcare Administration or related field

TYPICAL EXPERIENCE:

• 2 years recent relevant experience

SKILLS AND KNOWLEDGE:

• Knowledge of financial modeling and financial analysis principles, methods, practices, and procedures.
• Knowledge of managed care payment/reimbursement methodologies (e.g., Medicaid/Medi-Cal, Medicare, fee-for-service, capitation/sub-capitation) for various types of healthcare entities (e.g., hospital, skilled nursing facilities, physician, ancillary and professional service providers).
• Knowledge of healthcare/hospital accounting systems and audit processes.
• Familiar with healthcare contracting terminologies.
• Knowledge of healthcare/hospital operations and structure.
• Knowledgeable of the unique operational and financial reporting requirements that include incurred but not reported (IBNR) calculations/adjustments, Division of Financial Responsibility (DOFR) assessment and valuation, modeling and assessing plan health factors and population normalization principles.
• Ability to translate financial data and analysis into reports and presentations for appropriate audience.
• Critical thinking and quantitative analytical abilities to work with large and complex data sets.
• Organization skills and attention to details.
• Ability to read, comprehend, interpret and apply policies, procedures, practices, contract language, and regulatory and legal requirements, including financial reports.
• Displays a customer service focus in all decisions and actions.
• Ability to prioritize workload to complete assignments accurately and timely, and to meet strict timelines.
• Ability to communicate through verbal and written means, and to present information to a variety of audiences
• Ability to interact and maintain effective working relationships with those contacted in the performance of required duties.
• Demonstrates respect for cultural and linguistic differences and promotes an inclusive work environment.
• Demonstrates initiative in providing feedback/input to improve workflow/processes.
• Ability to work effectively in a dynamic and fast-paced environment with changing business priorities.
• Ability to maintain and work discreetly with confidential information.
• Ability to use essential applications and/or databases associated with the role’s duties and responsibilities.

 

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Monday - Friday

Weekend Requirements:

As Needed

Benefits:

Yes

Unions:

No

Position Status:

Non-Exempt

Weekly Hours:

40

Employee Status:

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $37.68 to $56.52 / hour

The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.